Outpatient Charges
What is the difference between an "inpatient" and "outpatient" procedure?
"Inpatient" procedures require that the patient be admitted into the hospital for at least an overnight stay. An "outpatient" procedure can be performed at a hospital but the patient does not typically need to be admitted before or after the procedure is performed. An exception to this definition is an observation patient. If you have questions about your patient classification, ask your hospital of choice.
How do you determine the "average charge" of a procedure?
The average charge amount is calculated by adding the total hospital charges for all patients in the last 12 months who obtained a specific outpatient test or procedure. This total number is then divided by the number of patients in that same category. The information below reflects calendar year 2005 outpatient billed patients.
Not all hospitals offer all procedures or tests. You should ask your hospital of choice about availability of the procedure or test on an outpatient basis.
When comparing charges, you should consider the likelihood that other procedures may be performed at the same time. For example, patients who undergo a left heart catheterization almost always undergo other procedures at the same time. Ask your physician if you are likely to undergo procedures other than the principal procedure. Insured and self pay patients may qualify for a payment amount less than the charged amount. Ask your hospital if you qualify for a payment less than charges.
Please also note that the charges are for the facility only. They do not include physician charges. Since these are statewide average charges per procedure or test, individual facility charges may vary significantly. You should ask your hospital for more current facility information.
| Category |
Test or Procedure
The number in parenthesis is the International Classification of Diseases (ICD-9-CM) procedure code
This information reflects calendar year 2005 outpatient billed patients.
|
Average Charge without another procedure |
Average Charge with another procedure |
| Eye |
Ultrasonic Destruction and Removal of Cataract (13.41) |
$4,954 |
$4,481 |
| Other Extra capsular lens extraction (13.59) |
$2,468 |
$5,827 |
| Insertion of Artificial lens at time of cataract extraction, 1 stage (13.71) |
$3,262 |
$5,635 |
| Ear |
Insertion of Drainage Tube into Ear (20.01) |
$2,074 |
$6,299 |
| Tonsil-Adenoid |
Removal of Tonsils and Adenoids (28.3) |
$4,715 |
$5,338 |
| Removal of Tonsils w/o Removal of Adenoids (28.2) |
$5,008 |
$6,818 |
| Removal of Adenoids (28.6) |
$4,550 |
$4,469 |
| Breast |
Needle Biopsy of Breast (85.11) |
$2,708 |
$3,858 |
| Local Excision of Lesion of Breast (85.21) |
$5,159 |
$7,795 |
| Shoulder |
Rotator Cuff Repair (83.63) |
$11,973 |
$14,094 |
| Other Removal/Destruction of Shoulder Joint Tissue (80.81) |
$9,228 |
$12,747 |
| Other Repair of Shoulder (81.83) |
$10,615 |
$12,034 |
| Carpal Tunnel |
Carpal Tunnel Release (04.43) |
$4,345 |
$6,150 |
| Knee |
Removal of Knee Cartilage (Meniscus) (80.6) |
$7,663 |
$8,530 |
| Removal/Destruction of Other Knee Cartilage (80.86) |
$7,385 |
$7,699 |
| Removal of Soft Tissue Lining (Synovium) from Knee (80.76) |
$6,984 |
$7,684 |
| Diagnostic Cardiac Catheterizations |
Left Heart Cardiac Catheterization (37.22) |
$11,627 |
$9,128 |
| Right & Left Heart Cardiac Catheterization (37.23) |
$13,918 |
$10,530 |
| Right Heart Cardiac Catheterization (37.21) |
$5,646 |
$9,839 |
| Gallbladder |
Laparoscopic Gallbladder Removal (51.23) |
$9,525 |
$10,575 |
| Appendix |
Laparoscopic Appendectomy (47.01) |
$13,373 |
$13,658 |
Esophagus/
Stomach/
Small Intestine |
Endoscopic Examination with Biopsy (45.16) |
$2,456 |
$3,538 |
| Other Endoscopic Examination of Small Intestine (45.13) |
$2,163 |
$2,888 |
| Dilation of Esophagus (42.92) |
$2,485 |
$2,787 |
| Endoscopic Removal/Destruction of Stomach Tissue or Lesion (43.41) |
$2,552 |
$3,622 |
| Colon |
Colonoscopy (45.23) |
$1,947 |
$2,922 |
| Endoscopic Biopsy of Large Intestine (45.25) |
$2,451 |
$3,030 |
| Endoscopic Examination of Sigmoidoscopy of Colon (45.24) |
$1,838 |
$2,146 |
| Endoscopic Removal/Destruction of Polyps - Large Intestine (45.42) |
$2,394 |
$3,308 |
| Endoscopic Removal/Destruction of Other Tissue - Large Intestine (45.43) |
$3011 |
$3,527 |
| Endoscopic Removal/Destruction of Polyps from Rectum (48.36) |
$2,368 |
$3,605 |
| Male Sterilization |
Vasectomy (63.73) |
$4,477 |
$6,982 |
| Female Sterilization |
Tubal Ligation (66.29) |
$6,304 |
$8,320 |